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Junior Doctors: Industrial Dispute

Volume 609: debated on Tuesday 10 May 2016

Talks are now taking place between NHS employers and the British Medical Association to try to resolve outstanding issues around the junior doctors’ contract.

In his recent letter to the head of the BMA, the Secretary of State offered to discuss improving work-life balance, especially for people with family responsibilities. How exactly does he plan to do that with a contract that the Government’s own quality impact assessment has identified as especially disadvantaging women?

That is not correct. It is worth saying that the reason for the dispute is a manifesto commitment to a seven-day NHS that the Government made to the people of England and that the Scottish National party has not made to the people of Scotland. The weekend effect does not happen just in England. There are studies in Scotland, including the Handel study, which states:

“The excess of admissions ending in deaths at weekends compared with those during weekdays seen elsewhere were also found in Scotland.”

I gently say to the hon. Gentleman that yes, we want to improve the quality of life for junior doctors so that they can live and work in the same city as their partners, and we are looking at the solution to that problem, but that he might think about doing the same thing in Scotland.

Will my right hon. Friend bear it in mind that Secretary of State Dean Rusk always said that jaw-jaw was better than war-war, and that it is welcome that the negotiations have resumed with the BMA on this difficult problem? Does he also accept that everyone wishes the talks well so that we can get a meaningful agreement that ensures a seven-day NHS for the benefit of patients and their safety?

My right hon. Friend speaks very wisely. Indeed, I was thinking about the talks as I spoke on my mobile phone and he was having a cigarette just outside the House yesterday morning. He is absolutely right about jaw-jaw. That is why I think that across the whole House we wish the talks well. However, for them to succeed all sides need to recognise their objective, which is a safer seven-day service for patients. I hope that, on that basis, we will be able to make progress.

I too am glad that the Secretary of State has reopened talks with the junior doctors, but I am a little concerned by the claim that the only issue is Saturday pay, whereas the doctors tell me that they fear the danger of exhaustion. Has he seen the analysis by Cass Business School suggesting that it is impossible to avoid high levels of fatigue under the new contract?

What I have done in the new contract is precisely to try to address those issues by reducing the maximum number of hours that junior doctors can be asked to work every week from 91 to 72 and by stopping junior doctors being asked to work six nights in a row or seven long days in a row. These are important steps forward, and the hon Lady may want to look at Channel 4 FactCheck and other independent analysis of the safety aspects of the new contract which say that this contract is a safer contract.

I would just say that stating it does not make it happen. Junior doctors have looked at the rotas that have been put out as exemplars, and they will not be able to avoid high levels of fatigue. Does the Secretary of State not recognise that, now that we have more data suggesting that the weekend effect may just be statistical, we actually require clinical research because he does not know exactly what the problem is that he is trying to fix?

The new data that the hon. Lady has talked about have been heavily contested this week by some of the most distinguished experts on mortality rates in the country. Academics do sometimes disagree, but Ministers have to decide. The fact is that the overwhelming evidence—whether it is on cancer, cardiac arrests, maternity or emergency surgery, and whether it is in big studies, small studies, UK studies or international studies—is that there is a weekend effect. This Government are determined to do something about it, and I gently say to the hon. Lady that she might consider whether something similar should be done in Scotland.

18. I am fully signed up to the national health service, and that is why I want to see the reopening of Chorley A&E as soon as possible. Many of my constituents use it.In his compromising mood, will my right hon. Friend ensure that, as he talks to the junior doctors, whom I value greatly, the one thing that he will not compromise on is delivering a full service seven days a week? (904954)

My hon. Friend is absolutely right. In the end, the British people’s passion for, and commitment to, the NHS is based upon its offering the highest standard of care for patients. It is sometimes difficult to take these decisions and sometimes we have arguments around them. I want to reassure him that my compromising mood is not a temporary thing. We have always wanted a negotiated solution, but there is one bit that we will not compromise on: the moment that the Government start doing things that mean that we are not delivering safe care for patients is the moment that we will fundamentally shake confidence in the NHS. This Government will not allow that to happen.